Patient Forms

Please take the time to completely fill out the following Online Health History Form and Read the Health Insurance Portability and Accountability At BEFORE your first appointment.   

  • Health Insurance Portability and Accountability Act [PDF]
  • Timing Your Appointment [PDF]

Please click SUBMIT when the form is completed.  This form will be securely sent following HIPAA guidelines to our webhost’s server.  We will have reviewed this information by the time you come for your appointment.

If you’re unable to open PDF files, you can get Adobe Reader® for free.

Thanks!

Irvine Orthodontics and Children’s Dental Specialists

PATIENT INFORMATION/EDUCATION

More info to be added soon!